Acute suicidal affective disturbance: Factorial structure and initial validation across psychiatric outpatient and inpatient samples.

BACKGROUND: A new clinical entity, Acute Suicidal Affective Disturbance (ASAD), was recently proposed to characterize rapid-onset, acute suicidality including the cardinal symptom of behavioral intent. This study examines the proposed ASAD criteria factor-analytically and in relation to correlates of suicidal behavior and existing psychiatric disorders in samples of psychiatric outpatients and inpatients. METHODS: Two samples of psychiatric outpatients (N=343, aged 18-71 years, 60.6% female, 74.9% White) and inpatients (N=7,698, aged 15-99 years, 57.2% female, 87.8% White) completed measures of their ASAD symptoms and psychological functioning. RESULTS: Across both samples, results of a confirmatory factor analysis supported the unidimensional nature of the ASAD construct. Additionally, results provided evidence for the convergent and discriminant validity of ASAD, demonstrating its relation to, yet distinction from, other psychiatric disorders and correlates of suicide in expected ways. Importantly, ASAD symptoms differentiated multiple attempters, single attempters, and non-attempters, as well as attempters, ideators, and non-suicidal patients, and was an indicator of past suicide attempts above and beyond symptoms of depression and other psychiatric disorders. LIMITATIONS: This study utilized cross-sectional data and did not use a standardized measure of ASAD. CONCLUSIONS: ASAD criteria formed a unidimensional construct that was associated with suicide-related variables and other psychiatric disorders in expected ways. If supported by future research, ASAD may fill a gap in the current diagnostic classification system (DSM-5) by characterizing and predicting acute suicide risk.

Evidence for the Propositions of the Interpersonal Theory of Suicide Among a Military Sample.

OBJECTIVE: Although the interpersonal theory of suicide may explain the elevated suicide risk among military service members, past explorations have been equivocal. This study aimed to investigate the propositions of the interpersonal theory in a sample of U.S. Army recruiters. METHOD: Participants (N = 3,428) completed self-report measures assessing the interpersonal theory's constructs (i.e., thwarted belongingness (TB), perceived burdensomeness (PB), acquired capability for suicide), current suicidal ideation, agitation, and insomnia. History of depression was obtained from medical records. RESULTS: Hierarchical multiple regression analyses revealed that the interaction between TB and PB was associated with current suicidal ideation, controlling for depression, agitation, and insomnia. This effect was especially notable among those with high capability for suicide. CONCLUSION: Findings provide support for the interpersonal theory in a large, diverse military sample. It may be advantageous to assess and therapeutically address TB and PB among at-risk service members.

The Association between Sleep Disturbances and Depression among Firefighters: Emotion Dysregulation as an Explanatory Factor.

STUDY OBJECTIVES: To investigate emotion regulation difficulties in association with self-reported insomnia symptoms, nightmares, and depression symptoms in a sample of current and retired firefighters. METHODS: A total of 880 current and retired United States firefighters completed a web-based survey of firefighter behavioral health. Self-report measures included the Center for Epidemiologic Studies Depression Scale, Insomnia Severity Index, PTSD Checklist, and Difficulties in Emotion Regulation Scale. RESULTS: A notable portion of participants reported clinically significant depression symptoms (39.6%) and insomnia symptoms (52.7%), as well as nightmare problems (19.2%), each of which demonstrated a strong association with emotion regulation difficulties (rs = 0.56-0.80). Bootstrapped mediation analyses revealed that the indirect effects of overall emotion regulation difficulties were significant both for the relationship between insomnia and depression (95% CI: 0.385-0.566) and nightmares and depression (95% CI: 1.445-2.365). Limited access to emotion regulation strategies emerged as the strongest, significant indirect effect for both relationships (insomnia 95% CI: 0.136-0.335; nightmares 95% CI: 0.887-1.931). CONCLUSIONS: Findings extend previous affective neuroscience research by providing evidence that insomnia and nightmares may influence depression symptoms specifically through the pathway of explicit emotion regulation difficulties. Sleep disturbances may impair the ability to access and leverage emotion regulation strategies effectively, thus conferring risk for negative affect and depression.

Who are we missing? Nondisclosure in online suicide risk screening questionnaires.

The use of self-report surveys for suicide risk screening is a key first step in identifying currently suicidal individuals and connecting them with appropriate follow-up assessment and care. Online methods for suicide risk screening are becoming more common, yet they present a number of complexities compared with traditional methods. This study aimed to assess whether forcing item responses may unintentionally hide or misrepresent otherwise useful missing suicide risk data. We investigated in secondary analyses of 3 independent samples of undergraduates (ns = 1,306; 694; 172) whether participants who chose not to respond specifically to current suicide risk screening items (i.e., Nondisclosers) scored significantly different from other risk response groups (i.e., Deniers, Lower-Risk Endorsers, and Higher-Risk Endorsers) on auxiliary measures related to suicidality. Multivariate Analysis of Variance (MANOVA) tests for each sample revealed that Nondisclosers were rare (ns = 7, 6, 7) and scored significantly higher than Deniers and similarly to Endorsers on suicide risk related measures. In 1 sample, Nondisclosers tended to score higher than all groups on suicide risk related measures. These findings suggest that nondisclosure for suicide risk screening questions is a preferred option for a distinct group of respondents who are likely at elevated suicide risk. Allowing for and flagging Nondisclosers for follow-up suicide risk assessment may be an ethical and feasible way to enhance the sensitivity of online suicide risk screenings for weary respondents, who if forced, may choose to underreport their suicide risk and misrepresent data. (PsycINFO Database Record

The influence of gender and age on the association between "fat-talk" and disordered eating: an examination in men and women from their 20s to their 50s.

Fat-talk is a common experience in college-aged women, yet little is known about fat-talk in men and across the lifespan. Exposure to fat-talk was compared in a large sample of men (n = 819) and women (n = 1,696) across four age cohorts. Greater exposure to fat-talk was associated with increased disordered eating for men and women. Men experienced less fat-talk than women. Age was negatively associated with fat-talk in women but not in men. Weaker associations between fat-talk and disordered eating were found in men compared to women and in older individuals compared to younger individuals. Nonetheless, the positive association between fat-talk and disordered eating in men and women from late adolescence to midlife and beyond indicates a need to extend intervention programs to target fat-talk in men and women across the lifespan.